ArticleAnnals of family medicine2017
The Challenges of Measuring, Improving, and Reporting Quality in Primary Care.
Article in Annals of family medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Attributes of family physician encounters valued by older adults: a systematic review.BMC primary care · 2025Pooled it
- The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Pooled it
- Ambulatory Medication Safety in Primary Care: A Systematic Review.Journal of the American Board of Family Medicine : JABFMPooled it
- Professional identity formation of family medicine residents in Singapore: a qualitative study to identify influencing factors.Annals of medicine · 2026Article
- Role of family medicine on health systems in the Americas: scoping review.Family medicine and community health · 2026Article
- "Kind of Feel Like the Lone Outpost": A Qualitative Exploration of Barriers to Professional Development for Rural Primary Care Providers at the Veterans Health Administration.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Article
- Essential Factors That Support National Implementation of Designated Registered Nurse Prescribing: A Systems-Thinking Approach.Journal of advanced nursing · 2026Article
- Family Physicians' Views of Who They Are Accountable To and Current Quality Metrics.JAMA network open · 2026Article
- Health Information Systems' Support for Management and Changing Work: Survey Study Among Physicians.JMIR medical informatics · 2025Article
- Article
- The contribution of Specialist Family Physicians to South Africa's private sector: A position statement.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- Quality indicators in respiratory therapy.World journal of critical care medicine · 2024Review
- Co-Design with Patients for Improving Patient Safety: Strategies, Barriers and pitfalls.Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting. Human Factors and Ergonomics Society. Annual meeting · 2023Article
- Primary care teams' reported actions to improve medication safety: a qualitative study with insights in high reliability organising.BMJ open quality · 2023Article
- Performing up to Nordic principles? Geographic and socioeconomic equity in ambulatory care sensitive conditions among older adults in capital areas of Denmark, Finland and Sweden in 2000-2015.BMC health services research · 2023Article
- Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program.BMJ open quality · 2022Article
- "Even though they insult us, the delivery they give us is the greatest thing": a qualitative study contextualizing women's experiences with facility-based maternal health care in Ethiopia.BMC pregnancy and childbirth · 2022Article
- Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis.PloS one · 2022Article
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear mechanical systems, such as isolated single-disease care, are inappropriate for nonlinear, complex adaptive systems, such as primary care, because of differences in care processes, outcome goals, and the validity of summative quality scorecards. Our priorities for primary care quality management include patient-centered reporting; quality goals not based on rigid targets; metrics that capture avoidance of excessive testing or treatment; attributes of primary care associated with better outcomes and lower costs; less emphasis on patient satisfaction scores; patient-centered outcomes, such as days of avoidable disability; and peer-led qualitative reviews of patterns of care, practice infrastructure, and intrapractice relationships.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.